BIOL 1080 Study Guide - Final Guide: Low-Density Lipoprotein, Metastasis, Synovial Fluid

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7 Apr 2016

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The final examination will be a multiple choice exam. Exam format: will be a mixture of two types of multiple choice questions. Question type 1 will be a direct, multiple choice question -- a stand-alone question that is not based on a situation or scenario. Question type 2 will be based on a situation (scenario); answering this type of question requires application of your knowledge of the course material to the situation. Learning lab #2 and 3 questions will be on the idp material. The material on the exam will be taken directly from: Independent learning lab #2 (as defined below) The number of questions (marks) on the final exam will be 62: 51 questions will. Note* material from the lecture afterthoughts is valuable as an aid for you to better understand the biological concepts of health and to learn how to apply the principles set out in the lecture portion of the course.

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Process Mapping: Hospital Response Chain (A Question for the course of Introduction to Information System)

When someone calls 9â1â1, there are a series of actions and responses that get triggered, collectively known as the preâhospital response chain. This chain is described below.

The Call for Help

When an individual experiences a medical, they typically call 9â1â1 for help. It is important that the patient stays on the phone to provide the necessary information about the emergency situation. The patient relays important information to both 9â1â1 and the health communication centre.

9â1â1 Emergency Service

The 9â1â1 dispatcher's responsibility is to take the 9â1â1 call for help and determine if the situation requires police, firefighters or ambulance services. In some emergency situations, more than one service can be dispatched2. The 9â1â1 dispatcher also needs to identify the patientâs location so that the appropriate type of ambulance can be dispatched (land, air or water)3. To make these assessments, there are a series of questions that are asked. The patient plays an important role in answering these questions. The 9â1â1 dispatcher collects all of the information needed to make these assessments and enters it into the 9â1â1 system. Once all the pertinent information has been collected, the information and call are then immediately transferred to the health communication centre. Otherwise, the dispatcher continues to work with the patient on understanding the situation.

Health Communication Centre

The health communication centreâs (HCC) responsibility is to review the information sent by the 9â1â1 dispatcher and speak to the patient to assess the nature of the situation and, most importantly, prioritize the response of the ambulance services. Additional information from the patient is typically required to do so. Prioritization is key in situations where there are multiple emergency situations. If the HCC dispatcher determines that the situation is urgent, the medical and emergency information, as captured in the HCC system, is transferred to the ambulance service, and the required number of ambulances dispatched to the scene. In situations that are not considered urgent, alternative methods of transportation are then arranged.

Ambulance Service

An ambulance service has a series of responsibilities when they are dispatched. The ambulance service is alerted to the emergency via their onâboard system. Using the location information provided, the ambulance service is then responsible for ensuring the appropriate route is taken using the navigational component of their onâboard system. Depending on the weather conditions, location, and time of day, the best route may change. Once the ambulance service arrives at the scene, they are responsible for assessing the situation and determining whether the patient needs to be stabilized at the scene first. Depending on location, assessment, and priority, the ambulance service first determines which hospital is best suited for the patient. If the patient requires stabilization, the ambulance service will work with that hospital to stabilize the patient. Specifically, they speak with the doctors at the hospital using their handsâfree mobile phones to relay the status of the patient and to receive stabilization instructions. The patient is not transported until they are in a stable condition. Once the patient is stabilized, the ambulance service continues to work with the doctors to determine whether the patientâs situation is still critical and requires hospital care. If that is no longer the case, the ambulance service will return to their dispatch station and complete a vehicle and supply report and a scene report.

On route to the hospital, the ambulance service will relay all critical information to the destination hospital using their onâboard system as well as calling them to provide an updated patient status and estimated time of arrival. This enables the hospital to complete all the necessary preparations. When the ambulance service arrives at the hospital with the patient, the patientâs status is verbally transferred to the receiving physician at that hospital. At this point, the physician and team of health professionals assess and care for the patient.

After the patient transfer is complete, there are a series of reports that need to be written and submitted by the ambulance services: 1, Patient Care and Transfer Report; 2, Scene Report (if needed) 3, Patient Invoice 4, Vehicle and Supply Report

The patient care and transfer report is used by the hospital to fill in the patient chart and can be used to determine onâgoing treatment. The ambulance service completes this report before leaving the hospital using their onâboard system and electronically submits it to the hospital. When this report is created, a scene report is not needed. A scene report is only created when the patient is not transferred to a local hospital, but assessment and care are provided at the scene. The scene report is for internal tracking purposes.

A patient invoice will be sent to the patient through the mail by the ambulance service: the typical cost for an ambulance service is $45 but if the receiving physician deemed the trip to be unnecessary, the bill will increase to $240. This information is provided by the physician in his verbal report to the ambulance service before they leave the hospital.

Finally, a vehicle and supply report will be created, for internal purposes, to track vehicle mileage, gas along with wear and tear. If there are any concerns with the vehicle or if maintenance is required the vehicle is sent to the fleet garage along with a paper report documenting the concerns. The vehicle is returned to the ambulance service when the repairs or maintenance are completed.

An inventory of the supplies on board the ambulance is taken and a list of the items needed to be replenished is electronically sent to the medical supplies warehouse via EDI for restocking. It is essential that those items are shipped quickly so that the ambulance is prepared for the next emergency. The ambulance always has reserves on board, but keeping those reserves replenished ensures they will not run out of supplies in an emergency situation.

Requirement: Draw the Process Map for the Hospital Chain Scenario

(Note: 1, Assume that the individual can call for 9â1â1 on their own. 2 In assignment we only have to focus on the land ambulance service; subâprocesses for the other services do not need to be elaborated on.)

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This includes showing all calculations and explaining why you selected a specific answer for each multiple choice question (i.e. donât just circle the correct answer). I am looking to see how you got the answer, not just that you have the correct answer.

Below is data from the United States Cancer Statistics about the number of news cases of lung cancer in males in the U.S. for 2011 for ages 30 and older.

Table 1: U.S. Population Size and Incidence Cases of Lung Cancer in Males for 2011

Age (Years)	U.S. Male Population	White Population	White Incidence Cases	Black Population	Black Incidence Cases
30-34	10,181,564	7,950,924	88	1,383,650	22
35-39	9,666,162	7,557,263	212	1,271,897	23
40-44	10,363,126	8,259,215	643	1,324,847	132
45-49	10,856,131	8,766,225	2,032	1,373,346	444
50-54	10,976,172	9,004,383	5,128	1,329,551	1,148
55-59	9,733,849	8,101,629	8,607	1,091,030	1,687
60-64	8,466,308	7,183,960	12,340	845,362	2,067
65-69	6,014,777	5,178,255	15,792	539,796	2,077
70-74	4,360,942	3,769,569	16,011	376,129	1,864
75-79	3,204,196	2,807,216	14,319	255,221	1,426
80-84	2,319,839	2,078,071	11,284	154,155	883
85+	1,873,942	1,688,433	7,616	117,267	545
Total	88,017,008	72,345,143	94,072	10,062,251	12,318

3. What is the age-specific incidence rate for lung cancer in white men age 75-79 for 2011?(1 pt)

0.005 per 1000

1.3 per 1000

1.2 per 1000

5.1 per 1000

5.6 per 1000

F. Cannot be calculated from the given information

4. What is the age-specific incidence rate for lung cancer in black men age 75-79 for 2011? (1 pt)

0.005 per 1000

1.3 per 1000

1.2 per 1000

5.1 per 1000

5.6 per 1000

F. Cannot be calculated from the given information

Questions 5 through 7 are based on the information below:

Using the information in Table 1, researchers calculated the crude incidence rates and age-adjusted incidence rates (via the direct method) for both groups.

Table 2: Crude incidence rates and age-adjusted incidence rates for white and black males

White Males		Black Males
Crude Incidence Rate	Age-adjusted Incidence Rate	Crude Incidence Rate	Age-adjusted Incidence Rate
1.3 per 1000	1.2 per 1000	1.2 per 1000	1.5 per 1000

5. True or False, there is likely a difference in the age composition between the white and black males. Explain your answer

6. Based on the information in Table 2, it was reported that there was an increased risk of lung cancer in black males in 2011. (1 pt)

The conclusion is:

Correct, the age-adjusted rate is higher in black males compared to white males

Correct, because both the crude and age-adjusted rates are higher in black males compared to white males

Incorrect, because the incidence rate for white males is actually higher than the incidence rate for black males

7. What type of age-adjusted rate was calculated in table 2? How does it differ from the age-adjusted rate in question 5 in the in-class exercise for age-adjustments? Hint: See slide title: Adjustments for Other Measures of Disease Frequency in the lecture title Adjusted Rates (1 pt)

Question 8 is based on the information given below:

Cause-specific mortality rates for men in 2010 in the U.S. from various types of cancers are shown in the table below:

Cause-Specific Mortality Rates

(per 100,000 Men)

Location of the Cancer

in the Body White Asian

Pancreas 13.2 5.7

Prostate 19.1 2.5

Lung 62.3 18.5

Skin 4.9 0.3

8. The inference that White men in the U.S. are at higher risk of death due to cancer of the pancreas, prostate, lung, and skin compared to Asian men in the U.S. is

A. correct

B. incorrect because of failure to determine cause-specific mortality rates

incorrect because proportionate mortality alone does not give an estimate of risk

D. incorrect because of failure to adjust for differences in the age composition of the two populations

E. incorrect because counts were used when cause-specific mortality rates were needed

9. In January 1996, a team of epidemiologists identified a sample of 4,500 men, 65-74 years of age, for a study of prostate cancer. Tests indicated that 315 of the men already had prostate cancer and, therefore, were not at risk. The rest of the men were followed prospectively for five years to determine the incidence rate of prostate cancer in the sample. By the end of the five years of follow-up 156 of the men had developed prostate cancer. What is the incidence rate of prostate cancer in this group?

10. An epidemiologic investigation that started on January 1, 2011, identified a population of 1,000 individuals. At the start of the study 4 were found to have the disease. During the year of study, 6 new cases were found; thus a total of 10 cases were identified. Among those 10 cases, 6 deaths occurred during the year. What was the prevalence of the disease during the 1-year study?

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BIOL 1080 Study Guide - Final Guide: Low-Density Lipoprotein, Metastasis, Synovial Fluid

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